Epidemiological survey of anterior segment diseases in Japanese isolated island using a portable slit-lamp device in home-based cases in Miyako Island

The ophthalmic diseases often affect the elderly and require proper diagnosis, treatments, and follow ups. However, many cases lack adequate eye care due to limited resources and decreased daily living activities among individuals. Despite the importance of ophthalmic home care, epidemiological research in this area has been lacking. This study utilized portable ophthalmological equipment to conduct an epidemiological research of anterior segment diseases in patients receiving home-based medical care in Japanese isolated island "Miyako island". A retrospective examination was conducted on home visit cases from a single facility in Miyako island (Dr. Gon Clinic). Data from 147 cases were collected and analyzed which the data are all recorded by the home care doctors and send the data to the cloud in order to make a diagnosis by the ophthalmologists. Findings included various anterior segment eye diseases such as Ptosis, meibomian gland dysfunction, conjunctival chalasis, corneal opacity, conjunctival hyperemia, pterygium, and cataract. Notably, over half of the cases (51.67%) had not undergone cataract surgery although the average age are notably high (85.69 ± 12.11 age of years). Among those without surgery, all showed signs of moderate to severe cataracts, with severity increasing with age. Additionally, a shallow anterior chamber depth was observed in one-third of these cases (33.63%) which considerable to receive a surgery to prevent the acute glaucoma attack. From our study, to ensure that patients in remote islands as Miyako island do not miss opportunities for eye care, there is an urgent need for the establishment of a supportive medical system.